Is treated hypertension associated with a lower 1-year mortality among older multimorbid residents of long -term care facilities?

INTRODUCTION Residents of long-term care facilities (LTCFs) are typically excluded from clinical trials due to multimorbidity, dementia, and frailty, so there are no clear evidence-based rules for treating arterial hypertension in this population. Moreover, the role of hypertension as a mortality risk factor in LTCFs has not yet been clearly established. OBJECTIVES The study aimed to investigate whether treated hypertension is associated with lower mortality among older LTCF residents with multimorbidity. PATIENTS AND METHODS The study was performed in 168 patients aged 65 years or older who were residents of 3 LTCFs. The initial assessment included blood pressure (BP) measurements and selected geriatric scales: the Mini Nutritional Assessment Short-Form, Abbreviated Mental Test Score, and Activities of Daily Living. Data on hypertension, comorbidities, pharmacotherapy, antihypertensive drugs, and mortality during 1-year follow-up were extracted from the medical records and were compared in survivors and the deceased. RESULTS Survivors and the deceased had similar age, diastolic BP, number of diseases, medications, and antihypertensive drugs. However, the deceased had lower systolic BP (P <0.05) and worse functional, nutritional, and cognitive status than survivors (P <0.001). Hypertension (P <0.001) and antihypertensive therapy (P <0.05) were significantly more frequent among survivors. More hypertensive-treated patients than other multimorbid residents survived follow-up (P <0.001). Multivariable logistic regression analysis showed that treated hypertension had a protective effect on mortality (odds ratio, 0.11; 95% CI, 0.03-0.39; P <0.001). CONCLUSIONS One-year survival of LTCF residents with treated hypertension was higher compared with others. Appropriate antihypertensive therapy may be a protective factor against death in frail nursing home residents, even short term.

Automated summary

Residents of long-term care facilities with treated hypertension had a higher one-year survival rate compared to those without. Appropriate antihypertensive therapy may serve as a protective factor against mortality in frail nursing home residents.